WATCHDOG: Used heroin needles litter streets, imperil lives

Sep. 21, 2013

Adam Reilly with a discarded syringe he found next to a bench on the southwest corner of 3rd and Vine Streets, downtown. He is involved with several groups fighting the areas heroin problem. He disposes of syringes he finds in biohazard sharps containers. / The Enquirer/Patrick Reddy

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Northern Kentucky and the rest of Greater Cincinnati are not equipped to deal with used needles spilling into their communities, a symptom of a heroin crisis that is creating a public health hazard affecting more people than those addicted to the drug.

“We are not prepared,” said Dr. Jeremy Engel, who chairs the Northern Kentucky Heroin Impact and Response Work Group. “We have got to come up with a plan that addresses that the needles themselves are causing harm.”

At least one person has contracted acute hepatitis C from handling a needle: A sanitation worker at Findlay Market was stuck in May with a discarded needle, said Dr. Judith Feinberg, professor of medicine at the University of Cincinnati. “He was picking up garbage, and he was stuck.”

“We’ve had calls like that,” said Patty Burns, coordinator of infection control at St. Elizabeth Healthcare. “We’ve always given people advice: Clean it. Go to the an emergency room or doctor. They will assess the risk.”

Leaders battling the heroin crisis – detailed in a March Enquirer report available at Cincinnati.com/heroin – say their attack must advance quickly to include a plan to minimize risk of people contracting infectious diseases from the discarded needles.

Intravenous heroin users liquify the drug and inject it, then frequently discard the syringe and hypodermic needle. Viruses can live in the liquid left in the device and can infect someone trying to clean up the litter if they are pricked by the needle. Needles are being found with increasing frequency on streets and sidewalks, in yards, parks, parking lots and other hubs of pedestrian traffic.

Burns said it’s difficult to assess how likely it is for people to get stuck and the degree of harm. “There are so many factors,” she said, including conditions of the syringes, the varying amounts of blood left in the syringes and whether the users had a virus.

Even so, Burns added, “The risk is there – especially for hepatitis B, C and HIV.”

Feinberg said hepatitis C, common to many IV drug users and clearly rising in the region, can live up to two weeks in the hub of the syringe.

“This is an enormous problem,” she said. “This is a regional problem.”

Needle-exchange program to be launched in Springdale, possibly by November

Engel and Feinberg advocate needle-exchange programs to help curb the prevalence of discarded needles.

Feinberg is leading efforts for the strategy with the Hamilton County Response to the Opioid Epidemic – and, after six years, getting results for the first time.

Springdale is embarking on its Infectious Disease Prevention Program, a needle-exchange program that could begin as soon as November.

Springdale Health Commissioner Cammie Mitrione said her city is neither more nor less plagued by the heroin epidemic than others, and the city council, health board and police department support the program.

Feinberg said the program will start with grant money she anticipates from Interact for Health, formerly the Health Foundation of Greater Cincinnati, in early November, but additional money will be needed to sustain it.

“I think it’s a way to acknowledge a problem that exists,” Mitrione said. “Hopefully it will take away the stigma in other places.”

Feinberg said such programs offer an opportunity to link addicts to treatment resources, which are scarce in the region. “They say, ‘Help me. Where can I go?’”

The NKY Heroin Response and Impact Work Group has been assessing the feasibility of a needle-exchange program, Engel said; however, no solid plans have developed yet.

Kentucky has no needle-exchange programs, according to Van Ingram, executive director of the state Office of Drug Control Policy. He said laws against drug paraphernalia could make it difficult to establish such programs.

Feinberg said a “safe area” must be established in a perimeter around needle-exchange programs, and law enforcement must be on board.

In Ohio’s Scioto County, Portsmouth Health Department has one of two such programs in the state; the other is in Cleveland.

Bobbi Bratchett, Linkage to Care coordinator for the department, said the Portsmouth needle-exchange program started in March 2011 and has led to cleaner streets and parks, where needles were formerly dropped.

Program workers exchanged 5,400 needles in the first nine months in 2011. That surged to about 8,400 per month since people began turning to heroin as their drug of choice, according to the health department’s records.

She attributed the increase to shutting down pill mills – where opioid addicts were able to get prescription painkillers easily – through the county and to heroin’s becoming more readily available to addicts. The Enquirer reported last month that Ohio officials say the crackdown on pill mills has further fueled use of heroin, which is plentiful and inexpensive.

Feinberg agreed needle-exchange programs help communities rid their streets of discarded needles because addicts must give a used needle in order to get one.

“They clean up the streets for you,” she said.

Where the needles are being found in our region

Scores of discarded needles have been found in a wide range of public places across the region, according to public health advocates, safety forces and residents.

A sampling of locations:

Newport Pavilion parking lot; behind Get Together Daycare at 2031 Dunlap St. and in the trash at Findlay Market, both in Over-the-Rhine; outside Party Source in Bellevue; a CVS parking lot in Corryville; a planter outside the YWCA in downtown Cincinnati; a trash can outside the Springdale Police Department; the Purple People Bridge; along Third Street in downtown Cincinnati; in the Mansion Hill neighborhood of Newport.

Police and health officials said people who see the tossed needles should not touch them, but alert store security or police so they can be disposed of safely and properly.

Bellevue Police Chief Wayne Turner said his department is collecting the needles, and every cruiser has a hazardous waste container. For now, they are piling up at the police department in a larger hazardous waste bin.

Feinberg said a public approach to the dropped dirty needles is the way to address the hazard involved. “This is much better dealt with out in the open than in the subterfuge,” she said.

Engel said his team has been focusing on life-saving and treatment approaches to the heroin problem in Northern Kentucky, but that it must simultaneously work toward ridding the region of discarded needles.

“There is an urgency behind this, and it just hasn’t been addressed,” Engel said. “We are going to have to start addressing it.

“We have an epidemic.”

Disposing of needles

Rumpke accepts “sharps” – or needles – but urges proper disposal.

• Drop needles into a rigid plastic container, such as a laundry detergent bottle; no water bottles.

• Seal the cap with thick tape and write “sharps” on the container.

• Drop the sealed container into your regular trash can.

• Do not put containers in with recycling.

The U.S. Environmental Protection Agency recommends community collections or needle-exchange programs.

Northern Kentucky Health Department does not advocate collection sites, because they require more handling of used needles.

I write the human side of issues that affect people in Covington, Newport and Campbell County. Email me at tdemio@nky.com.